title: [Treatment of refractory lateral epicondylitis with modified Nirschl surgical technique].
abstract: OBJECTIVE
  To investigate the clinical effects of modified Nirschl surgical techniique in treating refractory lateral epicondylitis.
  
  
  METHODS
  From March 2009 to January 2011,21 patients (21 elbows) with refractory lateral epicondylitis were treated in our hospital. There were 8 males and 13 females,ranged in age from 25 to 59 years with an average of (48.3+/-13.4) years and the duration time from 8 to 33 months with an average of (17.1+/-7.7) months;affected position in dominant sides of 16 cases and non-dominant sides of 5 cases. The patients had already received multiple non-operative treatments. Modified Nirschl surgical technique was performed,and operative origination from origin of musculus extensor carpi radialis brevis to discard process with small incision, the process place of extensor digitorum communis would be removed. The incisions were nursed by ice compress for 2 days after operation. Range of motion (ROM) and strengthening exercise of elbow joints started at the 1 week after plaster slab fixation; ROM and strengthening exercise of wrist joints also started at the 2 week after fixation. The pain, power of gripping and patient staisfaction were recorded after operation. Verhaar scaling were used to estimate the recovery.
  
  
  RESULTS
  Seventeen patients were followed up from 13 to 22 months with an average of 16.3 months. According to Verhaar standard, 15 cases obtained excellent results and 2 good. No postoperative complication such as instability was found.
  
  
  CONCLUSIONS
  Modified Nirschl surgical technique is an effective method in treating refractory lateral epicondylitis but correct to diagnosis and exclusion the coexisting diseases,accurate removal the process are important guarantee.
authors.affiliation: Department of Upper Limb Injury, Luoyang Orthopaedics Hospital, Luoyang 471002, Henan, China. zc205397@126.com
authors.forename: Chuan
authors.initials: C
authors.lastname: Zhang
authors.forename: Zuo-Jun
authors.initials: ZJ
authors.lastname: Zhang
authors.forename: Jun-Qi
authors.initials: JQ
authors.lastname: Wang
authors.forename: Su-Ling
authors.initials: SL
authors.lastname: Niu
authors.forename: Zhong-Xiao
authors.initials: ZX
authors.lastname: Chang
authors.forename: Ming
authors.initials: M
authors.lastname: Zhao
authors.forename: Lin-Ping
authors.initials: LP
authors.lastname: Yang
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Xu
authors.forename: Kai
authors.initials: K
authors.lastname: Xia
authors.forename: Fan-you
authors.initials: FY
authors.lastname: Ning
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013716:Tennis Elbow / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*